Locum Tenens Advice
Advice for Oral Board Exam
The anesthesia oral board exam will probably be the hardest exam you have ever taken. Not so much because it is technically difficult, but because it very different than any exam you’ve taken before. Of course, unless you already took it and are taking it again. The biggest key advice is to understand the exam and how you are evaluated. Let’s talk about the OSCE first.
OSCE
The OSCE is more straight forward easier to study for. This is because they give you a content outline and if you carefully go through the outline and go through all the links and samples you will cover all material they will examine.
The content outline can be found here.
https://www.theaba.org/wp-content/uploads/pdfs/OSCE_Content_Outline.pdf
Memorize how you are evaluated for each scenario and have a prepared statement for each evaluation item. You cannot just wing it because you do not have a lot of time. You need to go into every scenario understanding every point they are grading you on and have a statement prepared to address that point.
For example, in the communication and professionalism skill, they may ask you to consent a patient undergoing knee replacement surgery for either general or neuraxial anesthesia. This is probably a no-brainer and something you can do without much thought. However, did you remember the content outline? If you just introduced yourself, spoke of risk and benefits of general and neuraxial anesthesia and confirmed decision with patient, then you probably failed. Why?
Because the rubric per the content outline looks like this
The successful candidate will demonstrate the following behaviors:
• Demonstrates understanding of and concern for the situation of the patient
• Explains the indications for the proposed treatment options
• Explains conduct of proposed treatment options in lay terms
• Explains benefits and risks of treatment options, including both less severe/more common and more severe/less common relevant risks
• Discusses strategies for minimizing risks of the treatment options
• Elicits questions and responds appropriately in lay terms
• Confirms a final decision with the patient regarding the treatment options and obtains affirmative consent without coercion
There are points to be had by demonstrating concern for the patient.
“Hello, Mrs. Osce, I am Dr. X and I understand that you have a significant arthritis in your knee. I understand that this can be a stressful time and environment for you. You will receive excellent care at our facility. “ This should get you points for demonstrating understanding and concern. It’s easy to miss a statement like this if you just wing it.
Now go through each evaluation point and make sure you have a prepared statement. Regardless of the tasks they give you there should be significant overlap.
There will be a periprocedural complication. The rubric will look like this
• Elicits history relevant to the complication and current symptoms
• Performs focused physical evaluation if appropriate
• Discusses potential causes
• Discusses potential outcomes
• Presents plan for further evaluation and/or treatment if appropriate
• Elicits questions and responds appropriately in lay terms
• Demonstrates understanding of and concern for the situation of the patient
Again, when you practice make sure you touch on these points. Do the same
Now do the same for ethical issues, communication with other professionals using the rubrics provided in the content outline.
The public sample which is extremely useful as well. Go through this in its entirety.
https://www.theaba.org/wp-content/uploads/2023/01/Public-Sample-OSCE-all-stations-2023.pdf
Memorize the TTE views
https://anesthesiaeducation.net/aba_key_tee_views/
Memorize the pathologies
https://anesthesiaeducation.net/aba_pathologies/
I did not have experience doing TTE in residency. I would practice TTE probe on myself to learn how to get the views they want you to know.
Hope this is helpful. If all this was obvious to you then you should probably pass with flying colors anyway.
Standard Oral Examination
Again, the best thing you can do for orals is understand how the test is graded. It is an application of knowledge test. If you passed the applied then you have the knowledge, it is then time to prepare for orals. The best way to prepare is to practice taking exams a lot. If you study for orals like you did for the applied exam you will likely fail. I believe most people need to have significant amount of time simulating the exam to understand how it works. It’s like riding a bike or playing an instrument. You need to practice if you are expected to perform, you just can’t read about it.
The first question you need to ask yourself is whether you should take a course. If you are an at risk performer and have failed exams before then I would likely recommend paying for professional help. It is very expensive, however it is significantly less expensive than failing. If you have difficulty communicating or have language barriers, I recommend taking a course. The course essentially is forced practice on a large variety of topics.
Develop a technique to dissect the stems. The most effective for most people will be to organize by organ system. I found this method effective.
Now you need exams to practice. Get exams from your residency or purchase some books on amazon and have administer the exam. Study with other residents, former attendings, your spouse or anyone willing to read you the questions.I found these books especially helpful as adjuncts to practicing.